Director: Uncertainty looms in state mental health reform

More changes are coming to the state’s mental health system, but it will be a while before anyone knows what those changes will look like.

State leaders are still in the process of figuring out what’s working, what doesn’t and how much money they’ll have to spend, Dave Richard — the new director of N.C.’s mental health services —told a group of mental health advocates in Burlington on Thursday night.

“What you should know: This is not about someone trying to get rid of something. It’s about finding the best system to go forward. But (we) don’t feel the current system is sustainable. So let’s get it right now,” Richard said.

Richard was named the director of the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services on May 28. Since then, he’s been travelling the state meeting with consumer and family advisory committees — the state’s eyes and ears for mental health services on the ground. The division will plan reform based on their feedback.

Richard met with members of the committee for Alamance and 14 other counties Thursday. Cardinal Innovations Healthcare Solutions oversees mental health services in that area.

The possibility of more changes in an already tumultuous system — for a population that typically doesn’t adapt well to change — made some of the 30 or so gathered Thursday night uneasy.

As one woman put it: “We’re not Frosted Flakes or socks. We’re people. All this talk is cool, but we’ve gotten whipped around a lot. We may be crazy, but we’re not stupid. We’re still waiting on the ground-level, here.”

Committee member Rick Samuels asked Richard to listen hard to local voices to keep what works and what doesn’t.

Richard said the state’s focus will be to reduce administrative costs and funnel as much money as possible toward community services that help individuals. Anything above 15 percent of funding going toward administrating the system means that clients and patients aren’t getting the benefits they should, he said.

Of particular concern is the number of mentally ill who seek treatment in hospital emergency rooms. It’s much higher than the national average, Richard said, because North Carolina doesn’t have enough basic mental health services. Nine thousand people are on waiting lists for treatment, he said.

“We don’t have low-intensity services on the ground to keep people out of crisis. We have to figure out how to get those services in place and increase higher-intensity services,” Richard said. “What are we going to do about the emergency room situation? It’s unacceptable. People don’t get the right treatment, it’s a burden on hospitals and it’s putting people’s lives in jeopardy.”

He said he will work to open communication with other state departments — the department of transportation and education, specifically — to ease access to services.

Several reform plans are to the state next spring.

“Whatever the General Assembly ultimately allows is what will ultimately happen,” Richard said.